Monday, August 22, 2022

The Nurse as Tireless Patient Advocate

As highly respected healthcare professionals who often go above and beyond the call of duty, nurses are natural patient advocates. The nursing process may begin with assessment, but where the rubber hits the road is when nurses go to bat for their patients to make sure they receive the best possible care when they need it most. 

                                                                           Photo by @sjobjio on

Protecting the vulnerable

What does patient advocacy really mean? Our patients may be defenseless children, impoverished single mothers, or chronically mentally ill adults. From neglected seniors to isolated combat veterans with PTSD, patients often need nurses to be their voice and speak up when we see injustice, unfairness, and poor care.   
Patients are vulnerable. They may be diagnosed with life-threatening illnesses; weak from post-anesthesia recovery and pain; faced with homelessness and hunger; or be victims of violence, trafficking, or exploitation. Patient vulnerability comes in many flavors, and all deserve nurse advocacy.  

When a physician and a crowd of medical residents stand over a patient’s bed, speak in medical jargon, and act as if the patient isn’t a real live human being, the patient can feel alone and confused. 

A homeless schizophrenic patient enters the clinic, and everyone rolls their eyes and complains about the smell and the loud, irrational behavior. One nurse can choose to step up and defend that patient’s right to receive dignified, respectful care. 

A fearful young woman who doesn’t speak English is admitted to the emergency department after a brutal attack. The nurse can advocate that examinations must be performed by a Sexual Assault Nurse Examiner (SANE) and a professional skilled in evaluating for signs of human trafficking. 

When it comes to vulnerable patients, the nurse dedicated to being a powerful patient advocate can truly make a difference.

The nurse’s natural aim

Healthcare is all about the patient, and if nurses weren’t there like fierce tigers ready to fight for patients’ best interests, who would be there to do so?

Patients come first — we’re taught this concept from the first day of nursing school, or at least we should be. The patient’s feelings matter. The patient’s experience matters. The patient’s opinions matter. The patient’s choices matter. 

It can sometimes seem like the healthcare system doesn’t care about patients’ choices, feelings, experiences, or opinions at all. It can seem like the system does what it wants to, and patients are just inconvenient obstacles that pay the bills. 

Some nurses’ job descriptions make advocacy an official part of their responsibilities, but often the nurse will write advocacy into their job description because that’s what simply must happen during every shift.

We may think of the nurse’s natural habitat as the emergency department, the operating room, the school office, or the community health center. Wherever they work, the natural aim of the nurse is to be the lion or lioness ready to pounce at a moment’s notice with claws and teeth out. 

That condescending medical intern who talks to a grown male patient as if he’s a child? The nurse bully who sabotages other nurses’ patient care just to feel powerful? The surgeon who yells at a patient who doesn’t seem to understand her condition? They’re all at risk of being on the receiving end of the nurse advocate’s fangs as they spring from the grass and go for the jugular. 

Don’t you even think about talking to my patient and his family like that.”

My patient says his pain is 9 out of 10, and I believe him.

Would you want your mother treated the way you’re treating my patient right now?” 

What do you mean, my patient has to be discharged? He’s post-op, has no family or friends, and lives alone in a third-floor walk-up. He’s being discharged over my dead body — find him a rehab placement, and he stays here until you do.”

The nurse may also advocate in the state house, talking with legislators and trying to create change in that way. It’s all about the patients and the quality of care they receive. Whether the conversation is about safe staffing or access to health insurance, it still boils down to the same basic aim. 

The nurse advocate never rests

The nurse advocate can truly never rest. There’s always another patient, another situation, and something new to be a champion for. Healthcare is constantly evolving, and nurses need to develop their advocacy in response to the times. 

Patients may not truly understand how nurses advocate for them, but it doesn’t really matter to most nurses in the end. If patients receive high-quality care with their dignity, rights, and best interests intact, then a large part of the goal has already been achieved. 


Keith Carlson, RN, BSN, NC-BC, is a Board Certified Nurse Coach offering holistic career development for nurses and healthcare professionals. All things Nurse Keith can be found at

Keith is the host of The Nurse Keith Show, his solo podcast focused on career advice and inspiration for nurses. From 2012 until its sunset in 2017, Keith co-hosted RNFMRadio, a groundbreaking nursing podcast.

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the  nursing profession. written for,, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University,, Diabetes Lifestyle, the ANA blog,, American Nurse Today, Working Nurse Magazine, and other online and print publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality, social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. 

Living in beautiful Santa Fe, New Mexico, Keith shares a magical life with his partner, Shada McKenzie, a gifted, empathic, and highly skilled traditional astrologer and reader of the tarot. 

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